问曰∶新产妇人有三病∶一者病 (亦作痉),二者病郁冒,三者大便难,何谓也?师曰∶新产亡血虚,多汗出,喜
中风,故令病 。何故郁冒?师曰∶亡血复汗,寒多,故令郁冒。何故大便难?师曰∶亡津液,胃燥,故大便难。产妇
郁冒,其脉微弱,呕不能食,大便反坚,但头汗出,所以然者,血虚而厥,厥而必冒,冒家欲解,必大汗出,以血虚下
厥,孤阳上出,故但头汗出。所以生妇喜汗出者,亡阴血虚,阳气独盛,故当汗出,阴阳乃复。所以便坚者,呕不能食
也,小柴胡汤主之,病解能食。七、八日而更发热者,此为胃热气实,承气汤主之。方在《伤寒》中。
妇人产得风续之,数十日不解,头微痛,恶寒,时时有热,心下坚,干呕,汗出,虽久,阳旦证续在,可与阳旦,
方在《伤寒》中,桂枝是也。
妇人产后,中风发热,面正赤,喘而头痛,竹叶汤主之。
妇人产后腹中 痛,可与当归羊肉汤。
师曰∶产妇腹痛,烦满不得卧,法当枳实芍药散主之。假令不愈者,此为腹中有干血着脐下,与下瘀血汤。
妇人产后七、八日,无太阳证,少腹坚痛,此恶露不尽,不大便四、五日,趺阳脉微,实再倍,其人发热,日晡所
烦躁者,不能食,谵语,利之则愈,宜承气汤。以热在里,结在膀胱也。方在《伤寒》中。
妇人产中虚,烦乱呕逆,安中益气,竹皮大丸主之。
妇人热利,重下,新产虚极,白头翁加甘草汤主之。(《千金方》又加阿胶)
问:新近分娩的妇女有三种病:一种是痉病(亦作“痓”,指项背强直、口噤不开甚至角弓反张的病证),第二种是郁冒(指头晕目眩、意识模糊如被物蒙蔽的病证),第三种是大便难,这是什么原因呢?
老师说:新产之后,由于失血导致身体虚弱,加上出汗多,容易感受风邪,所以会导致痉病。为什么会出现郁冒呢?老师说:因为失血之后又出汗,寒邪较多,所以导致郁冒。为什么会出现大便难呢?老师说:因为津液耗伤,胃中干燥,所以导致大便难。
产妇出现郁冒时,脉象微弱,呕吐不能进食,大便反而干结,只有头部出汗。之所以这样,是因为血虚导致气逆上厥,气逆上厥必然导致头昏目眩。郁冒欲解之时,一定会全身大汗出。这是因为血虚导致下部气逆,孤阳上浮外越,所以只有头部出汗。之所以产妇容易出汗,是因为阴血亏损,阳气相对偏盛,所以应当出汗,待阴阳平衡恢复后,汗自止。之所以大便干结,是因为呕吐不能进食,可用小柴胡汤主治,病愈后能进食。
如果在产后七八日再次出现发热,这是胃中有热且气实所致,用承气汤主治。方剂在《伤寒论》中。
妇人产后感受风邪,症状持续数十日未解,轻微头痛,怕冷,时常有发热,心下痞硬,干呕,出汗。虽然病程较长,但阳旦证(即桂枝汤证)依然存在,可以使用阳旦汤(即桂枝汤)。方剂在《伤寒论》中,就是桂枝汤。
妇人产后腹中疼痛,可以用当归羊肉汤。
老师说:产妇腹痛,伴有烦闷胀满,无法躺卧,依法应当用枳实芍药散主治。如果服药后不愈,这是因为腹中有干血瘀滞于脐下,用下瘀血汤主治。
妇人产后七八日,没有太阳病的表证,少腹部坚硬疼痛,这是恶露未尽所致。如果四五天不大便,趺阳脉微而实,比正常强两倍,其人发热,傍晚时分烦躁不安,不能进食,谵语,使用泻下法即可痊愈,宜用承气汤。因为热邪在里,结聚在膀胱部位。方剂在《伤寒论》中。
妇人在生产过程中气血亏虚,心烦意乱,呕吐逆气,需要安中和益气,用竹皮大丸主治。
Question: There are three diseases in women who have just given birth: one is Jing disease (also written as "Chong," referring to a syndrome characterized by stiffness of the neck and back, locked jaw, or opisthotonos), the second is Yumao (referring to dizziness, blurred vision, and a sensation of mental clouding as if covered by an object), and the third is difficulty in defecation. What does this mean?
The Master said: After childbirth, there is blood loss leading to deficiency, accompanied by profuse sweating, making the body susceptible to Wind pathogenic factors, thus causing Jing disease. Why does Yumao occur? The Master said: Because of blood loss followed by sweating, with excessive Cold, Yumao results. Why is there difficulty in defecation? The Master said: Because of the depletion of Jin-Ye (body fluids), dryness in the Stomach, difficulty in defecation results.
When a postpartum woman suffers from Yumao, her pulse is faint and weak, she vomits and cannot eat, her stool becomes hard, and only sweat appears on the head. The reason for this is that Blood deficiency leads to Jue (reversal of Qi flow upwards); when Jue occurs, Yumao inevitably follows. For Yumao to resolve, there must be profuse sweating all over the body. This is because Blood deficiency causes Qi reversal in the lower part, and solitary Yang floats upward and outward, hence only the head sweats. Postpartum women tend to sweat because Yin-Blood is deficient, leaving Yang Qi relatively abundant; therefore, sweating should occur until Yin and Yang return to balance. The reason for hard stool is vomiting and inability to eat; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment, and once the illness resolves, appetite returns.
If fever recurs seven or eight days after childbirth, this indicates Heat in the Stomach with excess Qi; Cheng Qi Tang (Purgative Decoction) is the primary treatment. The formula is found in Shang Han Lun (Treatise on Cold Damage).
If a woman contracts Wind after childbirth and symptoms persist for dozens of days without resolving, accompanied by slight headache, aversion to cold, intermittent fever, hardness below the heart, dry vomiting, and sweating, even though the duration is long, if the Yang Dan syndrome (i.e., Gui Zhi Tang syndrome) persists, Yang Dan Tang (which is Gui Zhi Tang/Cinnamon Twig Decoction) can be administered. The formula is found in Shang Han Lun.
If a postpartum woman suffers from Wind attack with fever, flushed face, wheezing, and headache, Zhu Ye Tang (Bamboo Leaf Decoction) is the primary treatment.
If a postpartum woman suffers from abdominal pain, Dang Gui Shao Yang Tang (Angelica Sinensis and Mutton Decoction) can be used.
The Master said: If a postpartum woman suffers from abdominal pain accompanied by irritability, fullness, and inability to lie down, Zhi Shi Shao Yao San (Immature Bitter Orange and Peony Powder) is indicated according to the method. If it does not heal, this indicates dried Blood stagnating below the umbilicus; Xia Yu Xue Tang (Drain Stasis Blood Decoction) should be used.
Seven or eight days after childbirth, if there are no Tai Yang (Greater Yang) exterior signs, but the lower abdomen is hard and painful, this is due to incomplete expulsion of lochia. If there has been no bowel movement for four or five days, and the Du Yang pulse is faint yet solid, twice as strong as normal, accompanied by fever, evening restlessness, inability to eat, and delirious speech, purgation will lead to recovery; Cheng Qi Tang (Purgative Decoction) is appropriate. This is because Heat is interior and congealed in the Bladder region. The formula is found in Shang Han Lun.
If a woman is deficient during labor, suffering from mental disturbance, irritability, vomiting, and regurgitation, to calm the Middle and tonify Qi, Zhu Pi Da Wan (Bark Bamboo Large Pill) is the primary treatment.
If a woman suffers from hot dysentery with tenesmus, especially after childbirth when extreme deficiency exists, Bai Tou Weng Jia Gan Cao Tang (Pulsatilla Decoction with Added Licorice) is the primary treatment. (Qian Jin Fang adds E-Jiao/Donkey-Hide Gelatin).